Background: With the recent advent of percutaneous valve therapy, an increased need for the evaluation of outcomes after open aortic valve replacement (AVR) in elderly patients is warranted. This study compares the short- and long-term survival outcomes of octogenarians after AVR with younger age groups in the modern surgical era.
Methods: A retrospective review was performed on patients who underwent isolated, primary AVR from 1996 to 2006 at the Emory Healthcare Hospitals. Five-hundred fifteen patients were divided into three age groups: 60 to 69 (n = 206), 70 to 79 (n = 221), and 80 to 89 years of age (n = 88). Outcomes were compared among the age groups using logistic regression and analysis of variance techniques. Long-term survival between age groups was compared using the Cox proportional hazards model. Kaplan-Meier plots were used to determine survival rates.
Results: The groups were similar with respect to in-hospital mortality (p = 0.66) and hospital length of stay (p = 0.08). Preoperative predictors of in-hospital mortality included stroke (odds ratio [OR] 5.36), chronic lung disease (OR 4.51), and renal failure (OR 1.39). As expected, age significantly impacted long-term survival (hazard ratio [HR] 1.06). Other predictors of long-term survival included stroke (HR 2.15), current smoker (HR 2.03), diabetes (HR 1.53), and renal failure (HR 1.4). The Kaplan-Meier estimate of median survival for octogenarians was 7.4 years.
Conclusions: In the modern era, octogenarians have acceptable short- and long-term results after open AVR. Comparisons of less invasive techniques for AVR should rely on outcomes based in the modern era and decisions regarding surgical intervention in patients requiring AVR should not be based on age alone.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.athoracsur.2008.06.036 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Across a series of eight high-powered studies ( = 6,866), we develop a method for assessing impartial intergenerational beneficence, defined as intergenerational concern for all possible future generations. Across our studies, roughly 20% of participants displayed impartial intergenerational beneficence. Participants with impartial intergenerational beneficence expressed greater perceptions that future threats can be resolved, support for policies seeking to protect future generations of people, and a profound sense of responsibility for the long-term survival and prosperity of humanity.
View Article and Find Full Text PDFSarcopenia as a Prognostic Factor and Multimodal Interventions in Breast Cancer.
Int J Gen Med
December 2024
Department of Thyroid and Breast Surgery, Quzhou People's Hospital, Quzhou, 324000, People's Republic of China.
Objective: This study aims to demonstrate the impact of sarcopenia on the prognosis of early breast cancer and its role in early multimodal intervention.
Methods: The clinical data of patients (n=285) subjected to chemotherapy for early-stage breast cancer diagnosed pathologically between January 1, 2016, and December 31, 2020, in our hospital were retrospectively analyzed. Accordingly, the recruited subjects were divided into sarcopenia (n=85) and non-sarcopenia (n=200) groups according to CT diagnosis correlating with single-factor and multifactorial logistic regression analyses.
Endovascular treatment of postoperative aortic coarctation aneurysms-a single center experience.
Front Cardiovasc Med
December 2024
Department of Cardiology, University Hospital 'St. Ekaterina', Medical University of Sofia, Sofia, Bulgaria.
Background: Formation of local type aortic aneurysm years after surgical repair of coarctation (CoA) occurs in 10% of patients independent of the surgical technique and is a potentially life-threatening condition if left untreated with a high risk of aortic rupture. Redo open surgery is associated with 14% in-hospital mortality and a high risk of complications. Endovascular treatment appears to be a feasible alternative with a high success rate and low morbidity and mortality, but data concerning long-term results is still mandatory.
View Article and Find Full Text PDFDonor-derived cell-free DNA in chronic lung allograft dysfunction phenotypes: a pilot study.
Front Transplant
December 2024
Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of CHROMETA, KU Leuven, Leuven, Belgium.
Long-term survival after lung transplantation is limited due to chronic lung allograft dysfunction (CLAD), which encompasses two main phenotypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). Donor-derived cell-free DNA (dd-cfDNA) is a biomarker for (sub)clinical allograft injury and could be a tool for monitoring of lung allograft health across the (pre)clinical spectrum of CLAD. In this proof-of-concept study, we therefore assessed post-transplant plasma dd-cfDNA levels in 20 CLAD patients (11 BOS and 9 RAS) at three consecutive time points free from concurrent infection or acute rejection, during stable condition, preclinical CLAD, and established CLAD ( = 3 × 20 samples).
View Article and Find Full Text PDFNursing home acquired pneumonia (NHAP), and its subset - aspiration-associated pneumonia, is a leading cause of morbidity and mortality among residents in long-term care facilities (LTCFs). Understanding colonization dynamics of respiratory pathogens in LTCF residents is essential for effective infection control. This study examines the longitudinal trends in prevalence, persistence, bacterial load, and co-colonization patterns of five respiratory pathogens in three LTCFs in Phoenix, Arizona.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!